Goldstein Nira A, Gorynski Michael, Yip Candice, Harounian Jonathan, Huberman Harris, Weedon Jeremy
State University of New York Downstate Medical Center, Division of Pediatric Otolaryngology, 450 Clarkson Avenue, MSC 126, Brooklyn, NY 11203, USA.
State University of New York Downstate Medical Center, Division of Pediatric Otolaryngology, 450 Clarkson Avenue, MSC 126, Brooklyn, NY 11203, USA.
Int J Pediatr Otorhinolaryngol. 2016 Jun;85:107-11. doi: 10.1016/j.ijporl.2016.03.022. Epub 2016 Mar 28.
Our objective was to determine the developmental status of young children with sleep-disordered breathing (SDB) as measured by the Ages and Stages Questionnaire (ASQ-3) and to evaluate improvement after treatment.
The ASQ-3 was completed at entry, 3 months and 6 months after adenotonsillectomy or adenoidectomy. The questionnaire consists of 30 items that assess five domains: communication, gross motor, fine motor, problem solving and personal-social. Domain scores were compared with normative values: abnormal ≥2 SDs and borderline ≥1 but <2 SDs below the mean.
80 children, mean (SD) age 3.0 (0.94) years, 62.5% male, 77.5% African American, were enrolled. Median (range) apnea-hypopnea index (AHI) was 12.6 (1.4-178.5). At entry, 22 (27.5%) children scored in the abnormal range in at least one developmental area and an additional 23 (28.8%) had at least one borderline score. A generalized linear model including gender, AHI, maternal education and prematurity showed that only prematurity was an independent predictor of at least one abnormal or borderline entry score (likelihood ratio test p < 0.001). Adjusting for covariates and excluding children with a history of prematurity, the prevalence of at least one abnormal or borderline score (based on 112 observations of 70 children) was estimated at 49% (95% CI [37, 62]) at baseline; 34% (95% CI [17, 56]) at 3 months; and 22% (95% CI [10, 41]) at 6 months. Post-hoc pairwise comparison of time points showed the baseline versus 6-month difference to be statistically significant (p = 0.015).
The 27.5% baseline prevalence of abnormal ASQ scores in children with SDB indicates it is a risk factor for developmental delay. Significant improvements in score classifications were found 6 months after surgery.
我们的目的是通过年龄与发育进程问卷（ASQ-3）来确定睡眠呼吸障碍（SDB）幼儿的发育状况，并评估治疗后的改善情况。
在腺样体扁桃体切除术或腺样体切除术前、术后3个月和6个月完成ASQ-3。该问卷由30个项目组成，评估五个领域：沟通、大运动、精细运动、问题解决和个人社交。将各领域得分与标准值进行比较：异常为≥均值以下2个标准差，临界为≥均值以下1个但<2个标准差。
纳入80名儿童，平均（标准差）年龄3.0（0.94）岁，62.5%为男性，77.5%为非裔美国人。呼吸暂停低通气指数（AHI）中位数（范围）为12.6（1.4 - 178.5）。在入组时，22名（27.5%）儿童在至少一个发育领域得分处于异常范围，另外23名（28.8%）有至少一个临界得分。一个包括性别、AHI、母亲教育程度和早产情况的广义线性模型显示，只有早产是至少一个异常或临界入组得分的独立预测因素（似然比检验p<0.001）。在调整协变量并排除有早产史的儿童后，基于70名儿童的112次观察，至少一个异常或临界得分的患病率在基线时估计为49%（95%置信区间[37, 62]）；3个月时为34%（95%置信区间[17, 56]）；6个月时为22%（95%置信区间[10, 41]）。事后时间点两两比较显示基线与6个月时的差异具有统计学意义（p = 0.015）。
SDB儿童中ASQ得分异常的基线患病率为27.5%，表明这是发育迟缓的一个风险因素。术后6个月发现得分分类有显著改善。
